Changes in Patients’ Desired Control of Their Deep Brain Stimulation and Subjective Global Control Over the Course of Deep Brain Stimulation

Amanda R. Merner, Thomas Frazier, Paul J. Ford, Scott E. Cooper, Andre Machado, Brittany Lapin, Jerrold Vitek, Cynthia S. Kubu

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To examine changes in patients’ desired control of the deep brain stimulator (DBS) and perception of global life control throughout DBS. Methods: A consecutive cohort of 52 patients with Parkinson’s disease (PD) was recruited to participate in a prospective longitudinal study over three assessment points (pre-surgery, post-surgery months 3 and 6). Semi-structured interviews assessing participants’ desire for stimulation control and perception of global control were conducted at all three points. Qualitative data were coded using content analysis. Visual analog scales were embedded in the interviews to quantify participants’ perceptions of control over time. Results: Participants reported significant increases in their perception of global control over time and significant declines in their desired control of the stimulation. These changes were unrelated to improvements in motor symptoms. Improvements in global control were negatively correlated with a decline in desired stimulation control. Qualitative data indicate that participants have changed, nuanced levels of desired control over their stimulators. Increased global life control following DBS may be attributed to increased control over PD symptoms, increased ability to engage in valued activities, and increased overall self-regulation, while other domains related to global control remained unaffected by DBS. Conclusions: There are few empirical data documenting patients’ desire for stimulation control throughout neuromodulation and how stimulation control is related to other aspects of control despite the growing application of neuromodulation devices to treat a variety of disorders. Our data highlight distinctions in different types of control and have implications for the development of patient-controlled neurostimulation devices.

Original languageEnglish (US)
Article number642195
JournalFrontiers in Human Neuroscience
Volume15
DOIs
StatePublished - Feb 24 2021

Bibliographical note

Funding Information:
This study was supported by National Institute of Neurological Disorders and Stroke, Award Number RC1NS068086 and the National Institute of Mental Health, Award Number R01MH114853. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke, National Institute of Mental Health, or the National Institutes of Health.

Funding Information:
Funding. This study was supported by National Institute of Neurological Disorders and Stroke, Award Number RC1NS068086 and the National Institute of Mental Health, Award Number R01MH114853. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Neurological Disorders and Stroke, National Institute of Mental Health, or the National Institutes of Health.

Publisher Copyright:
© Copyright © 2021 Merner, Frazier, Ford, Cooper, Machado, Lapin, Vitek and Kubu.

Keywords

  • Parkinson’s disease
  • control
  • deep brain stimulation
  • ethics
  • neuromodulation

PubMed: MeSH publication types

  • Journal Article

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